October 2004
Dear Paula,
I am in my early 30s and have recently begun obsessing about my thinning hair. Through research on the Internet, I've found information about the possible link between stopping birth control pills and hair loss in women. This possibility would fit my situation and, of course, I am most curious to see if restarting the birth control pills will help to regrow some of the hair I have lost. Have you found research that would support the theory of hormone-related hair loss? If so, wouldn't hair be easily regrown with hormone supplements?

You have also mentioned saw palmetto, and I would like to try it. However, I can't find any information on this supplement, other than that it's geared toward men. Is it safe for women? Thank you so much. Unbiased beauty information is nearly impossible to find! What would we do without you?

Michelle, via email

Dear Michelle,
Birth control pills definitely affect hormones, but there are many conflicting opinions about their effect on hair loss or hair regrowth. Regrettably, there are few scientific studies on female pattern baldness, and even fewer when it comes to the effect of birth control pills on this condition. The small amount of research that does exist shows that some birth control pills have more testosterone-like activity, which can possibly promote hair loss by increasing the likelihood of testosterone being converted to dihydrotestosterone (DHT), the hormone by-product responsible for most hair loss. That would cause a number of hair follicles to lapse into the telogen phase (shedding) and then not begin the anagen phase (growth) again.

However, there are birth control pills that contain minimal amounts of testosterone or that have anti-androgenic properties (meaning they inhibit testosterone). These formulas can therefore reduce hair loss and may actually help hair grow on the head, while also reducing the risk of acne. When birth control pills contain estrogen, they can help reduce hair loss because estrogen makes hair stay on the head longer (Sources: Obstetrics and Gynecology, May 2003, pages 995-1007; Drugs, 2003, volume 63, issue 5, pages 463-492; and American Journal of Clinical Dermatology, 2002, volume 3, issue 8, pages 571-578).

Because there are so many other complicated and significant health issues related to taking birth control pills, hair loss and hair growth should not be the primary reason for taking them. It is essential for you to discuss all the pros and cons of these drugs at length with your physician.

Saw palmetto is a popular herbal supplement sometimes recommended for hair growth. However, there are absolutely no reliable studies that have investigated saw palmetto in relation to hair growth (the only one that does exist was performed by the company that sells a saw palmetto supplement, and it only studied ten people; given the special interest and the small sample number, this is not a reliable study). There are abundant studies for saw palmetto in relation to its ability to improve benign prostatic hyperplasia (BPH). Saw palmetto got its reputation for hair growth inadvertently due to the relationship between BPH and male pattern baldness, both of which are affected by the production of DHT. It was assumed that if saw palmetto could affect DHT, it was only a short stretch to believe it might be effective in treating male pattern baldness, too. But theory isn't always good medicine. There is also research suggesting that saw palmetto does not affect DHT and that it exerts some other action that may be the reason for the improvement in BPH symptoms. Further, there is no reason to assume that saw palmetto is safer than the prescription drug for hair regrowth Propecia (active drug ingredient finasteride). In fact, there are reports of similar side effects (Sources: www.naturaldatabase.com; Journal of the American Medical Association, November 1998, pages 1604-1609; American Family Physician, March 2003, pages 1281-1283; Urological Research, June 2000, pages 201-209; Cochrane Database of Systematic Reviews, 2002, volume 3; and www.hairlosstalk.com).